In spite of significant advances in diagnosis of prostate cancer (PCa), the detection and differential diagnosis of metastatic lymph node involvement remains an important clinical dilemma in a large number of cases. Contrast-enhanced abdominal computed tomography and magnetic resonance imaging (MRI), in part when using T1-weighed images (T1-WI and T2-WI), allow evaluating indirectly the presence of invasion in regional lymph nodes by assessing their diameter and morphology. Nonetheless, these techniques do not appear to be sufficiently sensitive for direct identification of lymph nodes with metastatic lesions. Aim: To study the significance of the apparent diffusion coefficient (ADC) of diffusion-weighted MRI in detection of metastatic lymph node involvement in PCa patients. Materials and Methods: The study involved 35 patients with histologically verified PCa. Based on multiparametric prostatic MRI findings and pathomorphological reports, we have performed ADC measurements for pelvic lymph nodes either with (n = 15, mean size 1.78 ± 0.59 cm) or without metastases (n = 20, mean size: 0.94 ± 0.06 cm) in PCa patients who underwent radical prostatectomy with lymph node dissection. Results: No significant differences
were observed when comparing mean sizes of N+ and N– pelvic lymph nodes. At the same time, when comparing mean ADC values for N+ and N– pelvic lymph nodes, we observed a statistically significant difference: 0.74 ± 0.09 · 10-3 mm2/s in metastatic lymph node vs 1.05 ± 0.23 · 10-3 mm2/s in lymph nodes without metastatic involvement (p < 0.001). Conclusion: The use of ADC for diffusion-weighted MRI may provide valuable information for detection of metastatic lymph node involvement in patients with PCa.
The work describes a case of rare neonatal systemic juvenile xanthogranuloma with an initial damage of the scalp, limbs, back and abdomen, multiple damages of the parenchyma of both lungs, spleen and liver with the development of a severe form of congenital cholestatic hepatitis. The diagnosis was established on the basis of histopathological and immunohistochemical examination of the skin nodules. The child on the background of therapy under the Langerhans cell histiocytosis III program achieved a partial response, which was manifested by a reduction of granulomatous formations on the skin, elimination of liver failure, but retained hepatosplenomegaly, specific lesions of the lung parenchyma, liver, and left kidney.
Against the background of cytostatic therapy, the patient developed secondary pancytopenia, perianal ulcerative-necrotic dermatitis with lesions on buttocks, stomatitis, protein-energy deficiency, acute liver failure. coagulopathy, disseminated intravascular coagulation syndrome, acute renal failure, respiratory failure of III degree, cardiovascular insufficiency of III degree, pulmonary edema, cerebral edema, cerebral coma of II–III degree, enterocolitis, intestinal paresis. Despite multicomponent intensive care, the child’s condition progressively deteriorated, and the patient died. The aspects of differential diagnosis of neonatal systemic juvenile xanthogranuloma are discussed.
the combined application of long non-coding RNAs (PCA3, DLX1, HOXC6, TMPRSS2:ERG) for obtaining the most accurate method of detection of PCa has not yet been comprehensively investigated.
Methods: In total 240 persons were included in the retrospective study. Among them were 150 patients with confirmed PCa, 30 patients with benign prostatic hyperplasia, 30 patients with active chronic prostatitis and 30 healthy volunteers. In all patients, the urine samples were collected prior to biopsy or treatment. Polymerase chain reaction with reverse transcription was performed to detect the expression level of PCA3, HOXC6, DLX1 and the presence of the TMPRSS2:ERG transcript.
Results: PCA3 was detected in urine samples in all cases. Using a PCA3 score of 56 allowed the differentiation between PCa and all other cases with a sensitivity of 61% and specificity of 96% (p < 0.001) while a PCA3 score threshold value of 50 resulted in a differentiation between clinically significant PCa (ISUP grades 2–5) and all other cases with a sensitivity of 93% and specificity of 93% (p < 0.001). The TMPRSS2:ERG expression in urine was detected exclusively in the group of patients with PCa and only in 16% of all cases.
Conclusions: PCA3 score detected in urine demonstrated moderate sensitivity and good specificity in differentiation between PCa and non-PCa and high sensitivity and specificity in differentiation between clinically significant PCa and non-PCa.
Monosodium glutamate (MG) is a popular food additive that is widely used for flavor enhancement. It is considered relatively safe for consumption in many countries since the time it was first discovered in 1907. However, various disorders have been attributed to MG exposure, while its toxic effects were reported in numerous studies. MG was associated with obesity, metabolic, gastrointestinal, reproductive and other disorders, while damage to satiety center was attributed to its use. However, some of the experimental studies conducted in the past had several flaws in their design or execution that presumably could have affected the results’ extrapolation onto the human population. Further studies are needed to establish monosodium glutamate role in induction and progression of vascular pathology, particularly its effects on the morphology of carotid sinus and adjacent structures, as information on this particular issue is scarce. The objective of this study was to analyze early morphologic changes of carotid sinus under the influence of a low dose of monosodium glutamate administered orally by means of electron microscopy in experimental setting. Carotid sinuses of 10 adult male albino rats were studied by electron microscopy following 4, 6 and 8 weeks of oral administration of 10 mg/kg monosodium glutamate daily. The data was compared with the results of morphologic study of carotid sinus in the control group of 10 adult male albino rats. The data obtained suggests that monosodium glutamate oral consumption is associated with alterations of carotid sinus wall consistent with dystrophy and hypoxia at the early stages of exposure and apoptosis, fibrosis and lipid transformation at the later stages, while carotid glomus shows signs of cellular damage and apoptosis at a slightly later point in time but then the alterations worsen progressively. Further investigation is needed to evaluate morphologic changes of carotid sinus and adjacent structures associated with monosodium glutamate withdrawal.